Author/Authors :
Kitahara, Hideki Department of Cardiovascular Medicine - Chiba University Graduate School of Medicine, Chiba, Japan , Mastuura, Kaoru Department of Cardiovascular Surgery - Chiba University Graduate School of Medicine, Chiba, Japan , Sugiura, Atsushi Department of Cardiovascular Medicine - Chiba University Graduate School of Medicine, Chiba, Japan , Yoshimura, Akiko Department of Anesthesiology - Chiba University Graduate School of Medicine, Chiba, Japan , Muramatsu, Takahiro Department of Anesthesiology - Chiba University Graduate School of Medicine, Chiba, Japan , Tamura, Yusaku Department of Cardiovascular Surgery - Chiba University Graduate School of Medicine, Chiba, Japan , Nakayama, Takashi Department of Cardiovascular Medicine - Chiba University Graduate School of Medicine, Chiba, Japan , Fujimoto, Yoshihide Department of Cardiovascular Medicine - Chiba University Graduate School of Medicine, Chiba, Japan , Matsumiya, Goro Department of Cardiovascular Surgery - Chiba University Graduate School of Medicine, Chiba, Japan , Kobayashi, Yoshio Department of Cardiovascular Medicine - Chiba University Graduate School of Medicine, Chiba, Japan
Abstract :
Left ventricular outflow tract (LVOT) obstruction is sometimes observed in patients with severe aortic stenosis (AS). It is still
controversial how to manage the remaining severe AS, when LVOT obstruction is well-controlled by medical therapy. We report
a case with acute recurrence of LVOT obstruction requiring emergent alcohol septal ablation (ASA) after transcatheter aortic
valve implantation (TAVI), even in a stable state on beta-blockers. For the ASA procedure, transesophageal echocardiography
was useful to clearly observe the perfusion area of the target septal branch by injecting microbubble contrast. Since it took some
time to cause the recurrence of LVOT obstruction in this case, careful evaluation should be done after TAVI in high-risk patients
for LVOT obstruction before terminating the TAVI procedure.
